A biased look at psychology in the world

Suicide

January 21, 2016

Suicide among U.S. Army soldiers remains a significant concern for both population health and personnel readiness, with firearms constituting the majority of soldier suicides. Means restriction, or removing an at-risk soldier’s access to lethal means, is a well-established procedure for reducing suicides. Nonetheless, various cultural, legal, and practical concerns may encumber firearms restriction implementation in the U.S. Army. A new article in the journal Military Psychology reviews policy relevant to firearms restriction, including federal laws, Department of Defense directives, and U.S. Army regulations. Recommendations are provided for providers and commanders that balance the rights of soldiers with the need to ensure safety. In particular, installation restriction, field settings, enlisting supportive others, unit engagement, and off-installation storage are discussed. These approaches span the public health intervention model, providing numerous potential avenues to a balanced approach for firearms restriction in preventing suicide.

January 14, 2016

Helium gas suicides have increased in England and Wales; easy-to-access descriptions of this method on the Internet may have contributed to this rise. In a new study published in the journal Crisis, researchers investigated the availability of information on using helium as a method of suicide and trends in searching about this method on the Internet. They analyzed trends in (a) Google searching (2004–2014) and (b) hits on a Wikipedia article describing helium as a method of suicide (2013–2014). They also investigated the extent to which helium was described as a method of suicide on web pages and discussion forums identified via Google. Results showed no evidence of rises in Internet searching about suicide using helium. News stories about helium suicides were associated with increased search activity. The Wikipedia article may have been temporarily altered to increase awareness of suicide using helium around the time of a celebrity suicide. Approximately one third of the links retrieved using Google searches for suicide methods mentioned helium. The authors concluded that information about helium as a suicide method is readily available on the Internet; the Wikipedia article describing its use was highly accessed following celebrity suicides. Availability of online information about this method may contribute to rises in helium suicides.

November 19, 2015

Combat veterans are at risk for several adverse outcomes such as posttraumatic stress disorder (PTSD), depression, hazardous alcohol use, and most critically, suicidal behaviors. The high rate of suicide in veterans has been understood as a correlate of PTSD and depression, but it is possible that certain specific types of combat experiences may lead to suicidal behaviors. Acts committed by veterans in the context of war such as killing may evoke a “moral injury,” which leads to thoughts of ending one’s life. A research project published recently in the journal Psychological Trauma examined relationships between combat experiences and suicidal ideation (SI) and PTSD in a sample of 68 Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) veterans (91% male, mean age = 32.31 years) who had screened positive for alcohol misuse. The researchers examined firing a weapon/killing in combat (Firing/Killing) and killing in combat (Killing) alone as predictors of SI and PTSD severity in both the full sample and men only. Results showed that firing/killing were associated with SI for the full sample and men only, and Killing showed a trend toward significance in predicting SI. Hierarchical regression analyses suggested that Firing/Killing did not predict PTSD for the full sample or men only, but Killing was predictive of PTSD for both samples. These results indicate that there may be differences in Firing/Killing and Killing alone in OEF/OIF veterans who screened positive for alcohol misuse. Thorough screening of combat experiences and addressing moral injury in returning combat veterans may help reduce high rates of suicide and PTSD.

November 13, 2015

It all began in 1933 when a Hungarian composer named Reszo Servess first wrote the melancholy classic, Gloomy Sunday. Born in Hungary in 1899, Servess was a largely self-taught musician with little to show for his career as a songwriter. One of the legends surrounding the song is that it was written in thirty minutes on a gloomy Sunday afternoon after Servess broke up with a girlfriend. The bleak lyrics that he had originally written for the song were later replaced with lyrics by his friend, Ladislas Javor. Even in its revised form, the lyrics “Gloomy is Sunday/With shadows I spend it all/My heart and I/Have decided to end it all” conveyed the underlying feeling of hopelessness and despair all too clearly.

While Gloomy Sunday attracted little notice at first, most sources agree that the first rash of suicides related to the song occurred in Hungary three years after it was written. A magazine article published in Time Magazine in 1936 described seventeen suicides that had been linked to the song including a shoemaker named Joseph Keller who had left a suicide note quoting the lyrics. Hungarian authorities later banned what international record companies would call the “Hungarian Suicide Song”.

The aggressive marketing campaign designed for the song's release played up its “spooky” reputation. While there were 79 subsequent recordings by American and British artists over the years, it was the Billie Holiday recording in 1941 that made Gloomy Sunday an international hit. To combat the song’s deadly reputation, the Holiday version was rewritten with an extra verse to provide a less despairing ending. Despite the changes, the urban legends surrounding the song and its legacy of death lingered for decades afterward. Not only did the song continue to be banned in Hungary but the British Broadcasting Corporation’s policy against playing the song in the U.K. was only lifted in 2002.

Given the urban legends that sprang up around the song, separating fact from fiction tends to be difficult. In a recent review of the Gloomy Sunday controversy, the rash of suicides in Hungary appear to be the most well-documented of the song-related deaths. Possible reasons for the song's association with suicide include the political and economic turmoil in Hungary during the 1930s and the elevated suicide rate among Hungarians compared to the rest of Europe. The song may well have helped reinforce preexisting feelings of hopelessness and despair in listeners.

On January 13, 1968, Reszo Servess, the composer who had started it all, committed suicide by jumping from the balcony of his his apartment at the age of 67. His obituary noted that Servess had complained of the success of his song and despaired of ever writing another hit. The fact that the composer of the song committed suicide himself helped to strengthen its fatal reputation (just about every Internet page dedicated to the Gloomy Sunday “suicide epidemic” refers to Servess’ suicide).

While Gloomy Sunday is not the only song that has been linked to suicides, it is by far the most well-known and has even been made into a movie. Other examples of suicide related song include Metallica’s Fade to Black, Blink 182’s Adam’s Song, and Ozzy Ozbourne’s Suicide Solution (Ozbourne was sued by the parents of a teenager who had committed suicide while listening to the song). Copycat suicides have also been sparked by celebrity suicides such as Kurt Cobain and Yukiko Okada (the term Yukko syndrome was coined in Japan due to the rash of deaths that followed Okada’s suicide).

Music continues to have a powerful effect on listeners and the possible role of certain songs in shaping human behaviour needs to be recognized. While Gloomy Sunday 's deadly legacy is largely urban legend, there is enough substance to warn of the potential dangers of cultural influences on the suicidally depressed.

*A hat tip to Dr. Steven Stack of Michigan's Wayne State University for providing me with a reprint of his research.

November 03, 2015

Given the popularity of the Internet and the instant access provided by smartphones, tablets, and mini-notebook computers, most youths go online for information on the topics they consider important. According to one U.K. survey, seventy percent of young people between the age of nine and sixteen spend at least ninety minutes online daily. But what about young people who are feeling suicidal and go online for information?

Many suicide information organizations have set up websites providing support and information about suicide as well as where to go for help in the community. Young adults often value online groups where they can get help to cope with their problems. For young people who spend much of their time online, these kind of support services can be literally lifesaving.

But there are online hazards as well for young people thinking of killing themselves. Online groups can provide advice on suicide methods instead and there have been cases in which suicide voyeurs actually encourage suicidal people to kill themselves. Chat rooms and bulletin boards for people who self-harm can provide people on the edge with a sense of community that can make self-harm seem more feasible. The recent increase in self-harm, especially among adolescent girls may be linked to the contagion effect that can arise from these kind of interactions.

A new research study published in the journal Crisis takes a look at different online resources available for young people considering suicide and the kind of message they are sending. Using common search terms that young people might use to find information on suicide, self-harm, and depression, over three hundred websites that can be potentially accessed by young people seeking information were identified. According to researchers at the Department of Psychiatry at Oxford University and the Department of Psychology at Bath, the results showed that, while 56.1 percent of sites provided advice on how to get help, an additional 15.8 percent of sites gave specific advice on how to commit suicide or self-harm. An additional 7 percent of these sites provided active encouragement, and 20.7 percent provided images of suicide. Some of the images were quite graphic including bleeding from wounds. Nearly a fifth of all sites (19 percent) provided forums where people could share stories about self-harm.

Among the search engines used, Bing was the most likely to link to sites providing advice self-harm sites or containing graphic images. Bing was also the most likely engine to link to sites encouraging self-harm (11.8 percent) while Google was the least likely (5.2 percent).

Based on these results, the researchers recommend that questions about Internet use be included when assessing young people at risk. Parents, teachers, and mental health professionals also need to be more vigilant about suicide issues and the kind of information that vulnerable adolescents and young adults might be getting online.

October 25, 2015

I'm going to be in Peru for the next week and I'm not sure about the kind of WiFi access I'll have down there so I likely won't be able to communicate much until I get back.

In the meantime, he is a brief piece I wrote about a remarkable TEDX video from two years ago.

“I was barely a teenager the first time I tried to kill myself. If I knew then what I know now, no, it probably wouldn’t have changed very much. And it probably wouldn’t have changed very much because sometimes it doesn’t matter what you know. What you feel takes over.”

It is with these simple words that Mark Henick began the talk he gave at the Fifth Annual TEDX conference held in September 2013 at Toronto’s Royal Conservatory of Music. The talk, titled “Why We Choose Suicide” has had more than a million and a half page views since first being posted on YouTube and, listening to the 27-year-old Cape Breton native as he describes his battles with his own inner demons, it’s not hard to see why. Now living in Toronto with his family, Mark Henrick works for the Ontario division of the Canadian Mental Health Association and is also on the board of Canada’s Mental Health Commission. When not working with suicidal clients, he spends much of his time speaking professionally about mental health issues through the National Speakers Bureau.

In describing his own suicide attempt as a teenager, he credits his survival to the intervention of a total stranger who talked him down from the overpass in his native town of Sydney, Nova Scotia as he was preparing to jump . "I was alone,” Henrick said. “ I had planned this out already, I knew what I was going to do, and I had the emotional vulnerability at that time and [was] upset enough to actually try to follow through with it.” Though an emergency crew was on the scene and a crowd had gathered (including one person who told him to jump), it was the stranger who grabbed him once Mark let go of the railing. “That was really the moment that I realized that I could be that person,” he said. “ I could reach out and help people ... so that's what I do now."

Judging from the comments to his video, many of them from people dealing with their own suicidal feelings, Mark Henrick’s mission is far from over. And he is well aware of that.

October 20, 2015

For people who are morbidly obese or who have health problems due to being overweight, weight loss or bariatric surgery can be a highly effective way of losing weight and improving health. But can it lead to a higher risk of suicide in some patients?

Typically involving reducing the size of the stomach using gastric bands or removing and/or resectioning parts of the stomach and small intestine, weight loss surgery has an extremely high success rate with many patients reporting losing sixty percent or more of body weight within three years of the procedure . The U.S. National Institutes of Health recommends weight loss surgery for patients with a body mass index of 35 or greater if they also have health problems linked to weight such as Type 2 diabetes or obstructive sleep apnea.

Here in Canada, weight loss surgery is becoming extremely common with more than six thousand operations being performed between 2013 and 2014, a sharp rise from the 1,600 conducted in 2006. Despite the medical benefits associated with weight loss surgery, a new research study suggests that the psychological costs for people who have the surgery but fail to lose the hoped-for weight can be far higher than has been previously realized. Conducted by a team of researchers at the Institute for Clinical Evaluative Sciences (ICES) located in Toronto, Ontario, the study followed more than eight thousand adults who underwent bariatric surgery between 2006 and 2011 to measure risk of suicide or self-harm attempts.

According to their results, which have just been published in the latest issue of the Journal of the American Medical Association-Surgery, one hundred and eleven patients had one hundred and fifty-eight self-harm emergencies during the three-year period follow-up. The most common form of self-harm was intentionally overdosing on medication with half of all attempts leading to hospitalization. Patients most likely to harm themselves following unsuccessful weight loss including those over age 35, have preexisting mental health issues, have low incomes, or who live in a rural area.

In discussing the depression that can often follow weight loss failure, Dr. Redeleier notes that "It's a particular concern in that it doesn't show up immediately. For the first couple of months after the surgery, there's no increase whatsoever. It mostly begins to appear in the second and third year. And that's where we think there's a need for much greater followup, It's after the first year ... often the psychologists and the social workers have moved their interest onto other cases. That's when there seems to be some missed opportunities for intervention."

October 15, 2015

An article in the Journal of the Canadian Academy of Child and Adolescent Psychiatry discusses effective suicide prevention strategies. Deaths by suicide, the leading cause of non-accidental death among youth in Canada, outnumber all deaths by diseases of the heart, lungs, kidney, gastrointestinal system and cancer combined. Unquestionably, this is a serious threat to public health and to the human capital of our nation; however, effective strategies to address this menace have been elusive. The quest for efficacious initiatives is not only compelling, but is expected in a society that values the young and invests in its future. We need programs that are creative and appealing, yet, more importantly, that provide clear benefit and absence of harm.

September 22, 2015

As the rest of the country marks Suicide Prevention Month, the suburb of Greenwood, Minnesota has been scarred by the discovery of five bodies bearing signs of traumatic injuries in a Greenwood home. The five bodies are all members of the same family and are believed to have been killed in a murder-suicide.

Dead are Brian Short and his wife Karen, both of whom were in their forties, and their three children, Cole, Madison, and Brooklyn, aged 17, 15, and 14. Police had initially declined to provide details of how they died but the gruesome story slowly unfolded. Apparently Brian Short, a former nurse and businessman, had shot and killed his three children as they lay sleeping in their bedrooms. His wife attempted to call 911 but Short tracked her to another bedroom and shot her. He then went into the garage and shot himself.

While police declined to discuss potential motives for Brian Short's actions, one source told reporters that the killings were "unspeakable" and that Short was apparently suffering from financial and mental health problems. Records indicate that he was the litigant in a federal lawsuit filed by a New Jersey-based company and that they were already planning to move out of their expensive home as a result. No suicide note had been left behind and neighbours are still speculating on what could have driven Brian Short, a man they all described as congenial, to do such a thing. Active on Facebook and Twitter, Short often provided details of his family including snapshots of his daughter's soccer games and even pictures of the family dog.

On the nursing site started by Brian Short, the notice of their deaths is still posted. "It is with great regret and a very heavy heart that I have to share some very sad news with you," the notice read. "There is no easy way to say this. We just found out this afternoon that Brian and his family have passed away. The news is calling it an apparent murder-suicide, but this has not been verified by the authorities and details have not yet been released. No matter what the details are, the results are still the same," the notice continued, "A very tragic loss for the extended families, friends, co-workers, and this nursing community."

Friends and neighbours of the Shorts were quick to tell media of their own shock and grief over the deaths. Toni Plante, whose daughter went to school with the youngest Short daughter had texted Karen Short when she saw that Brooklyn Short had been away the first day of school. She received no response. "This is just too sad," she said. "They were the nicest people in the world. There was nothing snooty about them at all. They were just down to earth."

August 03, 2015

Of the 50,000 or more violent deaths occurring in the United States each year, the overwhelming majority involve death by firearm. According to Center for Disease Control statistics, 30 firearm-related homicides and 53 firearm-related suicides take place each day and those statistics don't even include deaths occurring due to accidental shootings. Though the entire issue of gun safety in the United States continues to be a major source of controversy, both politically and socially, actual policies that can reduce gun deaths tend to be difficult to implement and even harder to enforce.

Whatever your stand happens to be regarding gun control, one thing that we can all agree on is that there are some people who simply cannot be trusted with guns. Virtually all of the recent tragic incidents which have taken place in recent years, including the shootings at Sandy Hook Elementary School, the Colorado movie theatre, the Tuscon, Arizona constituents' meeting, and at Virginia Techs have certain common elements. They all involve mentally ill shooters using large-capacity firearms to kill as many people as possible before authorities could intervene. Many of these shooters also have a history of social isolation, emotional abuse, and often have a history of being bullied as well.